P0428 Cardiac Sympathetic and Parasympathetic Balance Before and After Gluten Free Diet in Children With Celiac Disease

Celiac disease (CD) is often associated with other autoimmune disorders such as IDDM, autoimmune thyroiditis, rheumatoid arthritis, idiopathic dilated cardiomyopathy. Recently, an increased prevalence of antibodies versus neurons of central and enteric autonomic nervous system has been reported in celiac patients affected by various neurological disorders with improvement of neurological sign in a high percentage of patients after gluten free diet (GFD). We wished to evaluate the cardiac sympathetic and parasympathetic balance (detected with time and frequency analysis of Heart Rate Variability [HRV]) in untreated CD children. Data were compared with healthy subjects and the same patients after GFD. Methods: 10 children with CD (mean age 8.4±3.9 years) were studied at diagnosis and after six months of GFD. The control group consisted of 10 healthy age, sex and weight matched children. Standard 12-lead electrocardiograms (ECG) and ECG monitoring in two leads for HRV evaluation were performed in all patients at diagnosis and after six months of GFD, under standardized experimental conditions. The analysis of the normal beat to beat series (612 interval) and the analysis of variability of R-R interval were performed in time and in frequency domain with a commercially available software (Norav System). All recordings were also visually examined and manually revised to verify beat classification. The following indexes were calculated in time domain: R-R mean length SDNN (standard deviation of all normal RR intervals), rMSSD (square root of the mean of the sum of the squares of differences between adjacent intervals), triangular Index. The following indexes were calculated for spectral analysis: low frequency (LF) power (0.04 to 0.15 Hz) in ms2, high frequency (HF) and LF/HF ratio. Ultra low frequency (ULF) and very low frequency (VLF) were not calculated because they reflect circadian and other long-term variations in heart rhythm. Statistics results were analysed by the Student's t Test.